Noravesh Farhad, Behbahan Seyed Ehsan Beladian, Saeediankia Afsaneh, Bahadorimonfared Ayad, Looha Mehdi Azizmohammad, Mohammadi Gohar
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2025 Apr 4;25(1):1282. doi: 10.1186/s12889-025-22202-8.
Lip and oral cavity cancer (LOCC) is a significant public health concern worldwide. This study investigated the long-term trends in the LOCC burden in Iran from 1990 to 2021.
We analyzed LOCC burden in Iran from 1990 to 2021 using the Global Burden of Disease (GBD) 2021 dataset, focusing on age-standardized disability-adjusted life years (ASDR), mortality rates (ASMR), and incidence rates (ASIR) stratified by sex and province. Joinpoint regression analysis was used to identify temporal trends, and the annual percent change (APC) and average APC (AAPC) were calculated. Future projections up to 2040 were generated using a hybrid forecasting model (ARIMA, ETS, and neural networks). Spatial analysis detected hotspot and coldspot regions in 1990 and 2021.
We observed a significant increase in the LOCC burden across all three indicators (disability-adjusted life years [DALY], ASMR, and ASIR) from 1990 to 2021. Joinpoint analysis revealed significant temporal trends, with an overall upward trajectory in the AAPC for both sexes combined and separately. Specifically, the overall AAPC for the ASDR was 0.34% (95% confidence interval [CI]: 0.26,0.39) for both sexes, 0.40% (95% CI: 0.32,0.45) for females, and 0.35% (95% CI: 0.27,0.42) for males. For the ASMR, the overall AAPC was 0.41% (95% CI: 0.34,0.46), 0.54% (95% CI: 0.48,0.58) for females, and 0.36% (95% CI: 0.29,0.42) for males. Similarly, the overall AAPC for ASIR was 1.33% (95% CI: 1.24,1.40), 1.51% (95% CI: 1.43,1.59) for females, and 1.26% (95% CI: 1.17,1.33) for males. Geographic variations were evident, with most provinces exhibiting increasing ASDR and ASMR, while ASIR displayed a consistent upward trend across all provinces. Notably, females showed a slightly more pronounced increase in ASDR, ASMR, and ASIR compared to males. Projections indicate a declining trend in DALYs, a fluctuating but stable mortality rate, and a continuous rise in incidence by 2040. Spatial analysis indicated no significant spatial autocorrelation at the national level in both 1990 and 2021.
Our findings highlight a rising burden of LOCC in Iran, with future projections indicating a growing incidence rate. Targeted public health interventions addressing regional disparities and risk factors are crucial. Sex-specific and region-specific policies, along with early detection strategies, are essential to mitigate the disease burden.
唇癌和口腔癌（LOCC）是全球重大的公共卫生问题。本研究调查了1990年至2021年伊朗唇癌和口腔癌负担的长期趋势。
我们使用《2021年全球疾病负担》（GBD）数据集分析了1990年至2021年伊朗的唇癌和口腔癌负担，重点关注按性别和省份分层的年龄标准化残疾调整生命年（ASDR）、死亡率（ASMR）和发病率（ASIR）。采用Joinpoint回归分析确定时间趋势，并计算年度百分比变化（APC）和平均APC（AAPC）。使用混合预测模型（ARIMA、ETS和神经网络）生成了截至2040年的未来预测。空间分析检测了1990年和2021年的热点和冷点地区。
我们观察到，从1990年到2021年，所有三个指标（残疾调整生命年[DALY]、ASMR和ASIR）的唇癌和口腔癌负担均显著增加。Joinpoint分析显示出显著的时间趋势，男性和女性合并及单独的AAPC总体呈上升轨迹。具体而言，ASDR的总体AAPC在男性和女性中分别为0.34%（95%置信区间[CI]：0.26，0.39）、女性为0.40%（95%CI：0.32，0.45）、男性为0.35%（95%CI：0.27，0.42）。对于ASMR，总体AAPC为0.41%（95%CI：0.34，0.46），女性为0.54%（95%CI：0.48，0.58），男性为0.36%（95%CI：0.29，0.42）。同样，ASIR的总体AAPC为1.33%（95%CI：1.24，1.40），女性为1.51%（95%CI：1.43，1.59），男性为1.26%（95%CI：1.17，1.33）。地理差异明显，大多数省份的ASDR和ASMR呈上升趋势，而所有省份的ASIR均呈持续上升趋势。值得注意的是，与男性相比，女性的ASDR、ASMR和ASIR增长略为明显。预测表明，到2040年，DALY呈下降趋势，死亡率波动但稳定，发病率持续上升。空间分析表明，1990年和2021年在国家层面均无显著的空间自相关性。
我们的研究结果凸显了伊朗唇癌和口腔癌负担的上升，未来预测表明发病率将不断上升。针对地区差异和风险因素的有针对性的公共卫生干预措施至关重要。针对性别和地区的政策以及早期检测策略对于减轻疾病负担至关重要。
